Factors affecting long-term survival of patients undergoing aortic surgery using the antegrade selective cerebral perfusion technique
Turkish Journal of Thoracic and Cardiovascular Surgery, cilt.22, sa.1, ss.13-18, 2014 (SCI-Expanded, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 22 Sayı: 1
- Basım Tarihi: 2014
- Doi Numarası: 10.5606/tgkdc.dergisi.2014.8205
- Dergi Adı: Turkish Journal of Thoracic and Cardiovascular Surgery
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.13-18
- Anahtar Kelimeler: Aortic aneurysm, dissecting aneurysm, follow-up studies, morbidity, mortality
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: This study aims to investigate the factors effecting long-term survival of patients undergoing ascending and arcus aortic aneurysm repair and/or dissection surgery using the antegrade selective cerebral perfusion (ASCP) technique. Methods: Between January 2000 and December 2008, 154 operative survivors of 177 patients (89 males, 65 females; mean age 54.5±12.4 years; range 20 to 84 years) w ho were operated in our clinic using the ASCP technique and discharged from t he hospital were included in the study. Eighty-four patients (54.5%) underwent dissection repair, while 70 (45.5%) underwent aneurysm repair. Patients who survived during the follow-up period were classified as group 1 and those who died were classified as group 2. Results: The mean follow-up period was 50.5±26.8 (range 3-106) months. Ten patients died during the follow-up period. The mortality rate was 6.49%. The length of intensive care unit stay (p<0.05), and blood and fresh frozen plasma (FFP) transfusion volume (p<0.05 for both) were higher in group 2. The length of intensive care unit stay was longer in patients with comorbid coronary artery disease (p<0.05), bleeding, cardiac tamponade (p<0.005), prolonged ventilation (p<0.001), and those on inotropic support (p<0.001). Logistic regression analysis of the variables with significant differences between the two groups revealed that the blood transfusion was an independent predictor for long-term survival (OR 1.33, 95% CI; 1.02-1.74, p=0.035). The probability of actuarial survival was found to be 98%, 94.8% and 93.5% at one, five and ten years, respectively. Conclusion: Prolonged length of intensive care stay along with associated risk factors may affect the long-term survival of the patients operated using the ASCP technique. These risk factors should be established and controlled, while vascular risk factors should also be considered to achieve a long-term survival.